This invention relates generally to a communication system for medical applications and monitoring of equipment used in the care of hospitalized patients. More particularly this invention uses a telecommunications network to provide a real-time, continuous data transfer from patient monitoring equipment into a computer system that continuously assesses such monitored data for medical assessment, tracking of progress of treatment, and other applications for hospitalized patients in geographically dispersed locations.
While the severity of illness of hospitalized patients over the past 15 years has increased dramatically, the level of and type of care of those patients has remained constant. Most hospitalized patients receive brief minutes of attention during morning rounds from physicians with limited critical care experience. During the remainder of the day and night, nurses are the primary caregivers, with specialists called only after patient conditions have started to deteriorate. The result of this mismatch between severity of illness and physician coverage is an unacceptably high mortality rate. In ICUs, where patients are assumed to get the best care, the mortality rate is 10% nationwide, and marked by a high prevalence of avoidable errors that result in clinical complications. In 1998, the Institute of Medicine (IOM) determined that avoidable patient complications were responsible for 98,000 deaths per year and was the single largest problem in medical care delivery. A 2003 study estimated that 18 patient safety indicators attributed $9.3 billion in excess charges per year and a more recent study (Health Grades Quality Study—July 2004) estimated that the IOM study had grossly underestimated the avoidable deaths and that the figure was closer to 190,000 deaths per year.
Numerous studies have shown that increasing the involvement of skilled care providers with patients can markedly improve patient outcomes. While providing additional skilled care providers would seem an obvious solution, current trends suggest that the demand for skilled care providers will continue to exceed the supply.
Attempts to automate various aspects of patient care have been the subject of various inventions. For example, U.S. Pat. No. 5,868,669 to Iliff was issued for “Computerized Medical Diagnostic and Treatment Advice System.” The disclosed invention is for a system and method for providing computerized knowledge based medical diagnostic and treatment advice to the general public over a telephone network.
U.S. Pat. No. 5,823,948 to Ross, Jr. et al was issued for “Medical Records Documentation, Tracking and Order Entry System”. The disclosed invention is for a system and method that computerizes medical records, documentation, tracking and order entries. A teleconferencing system is employed to allow patient and medical personnel to communicate with each other. A video system can be employed to videotape a patient's consent.
U.S. Pat. No. 4,878,175 to Norden-Paul et al. was issued for A Method for Generating Patient-Specific Flowsheets By Adding/Deleting Parameters.” The disclosed invention is for an automated clinical records system for automated entry of bedside equipment results, such as an EKG monitor, respirator, etc. The system allows for information to be entered at the bedside using a terminal having input means and a video display.
U.S. Pat. No. 5,544,649 to David et al. was issued for Ambulatory Patient Health Monitoring Techniques Utilizing Interactive Visual Communications.” The disclosed invention is for an interactive visual system, which allows monitoring of patients at remote sites, such as the patient's home. Electronic equipment and sensors are used at the remote site to obtain data from the patient, which is sent to the monitoring site. The monitoring site can display and save the video, audio and patients data.
U.S. Pat. No. 5,867,821 to Ballantyne et al. was issued for “Method and Apparatus for Electronically Accessing and Distributing Personal Health Care Information and Services in Hospitals and Homes.” The disclosed invention is for an automated system and method for distribution and administration of medical services, entertainment services, and electronic health records for health care facilities.
U.S. Patent No. 5,832,450 to Myers et al. issued for “Electronic Medical Record Using Text Database.” The disclosed invention is for an electronic medical record system, which stores data about patient encounters arising from a content generator in freeform text.
U.S. Pat. No. 5,812,983 to Kumagai was issued for “Computer Medical File and Chart System.” The disclosed invention is for a system and method which integrates and displays medical data in which a computer program links a flow sheet of a medical record to medical charts.
U.S. Pat. No. 4,489,387 to Lamb et al. was issued for “Method and Apparatus for Coordinating Medical Procedures.” The disclosed invention is for a method and apparatus that coordinates two or more medical teams to evaluate and treat a patient at the same time without repeating the same steps.
U.S. Pat. No. 4,731,725 to Suto et al. issued for “Data Processing System which Suggests a Pattern of Medical Tests to Reduce the Number of Tests Necessary to Confirm or Deny a Diagnosis.” The disclosed invention is for a data processing system that uses decision trees for diagnosing a patient's symptoms to confirm or deny the patient's ailment.
U.S. Pat. No. 5,255,187 to Sorensen issued for “Computer Aided Medical Diagnostic Method and Apparatus.” The disclosed invention is for an interactive computerized diagnostic system which relies on color codes which signify the presence or absence of the possibility of a disease based on the symptoms a physician provides the system.
U.S. Pat. No. 5,839,438 to Chen et al. issued for “Intelligent Remote Visual Monitoring System for Home Health Care Service.” The disclosed invention is for a computer-based remote visual monitoring system, which provides in-home patient health care from a remote location via ordinary telephone lines.
U.S. Pat. No. 5,842,978 to Levy was issued for “Supplemental Audio Visual Emergency Reviewing Apparatus and Method.” The disclosed invention is for a system which videotapes a patient and superimposes the patient's vital statistics onto the videotape.
U.S. Pat. No. 6,364,834 issued to Reuss, et al. was issued for a “Method and System for Remotely Monitoring Multiple Medical Parameters in an Integrated Medical Monitoring System.” The disclosed invention is for an integrated medical monitoring system having a patient monitor, a central monitor, and a remote access device. Each of these devices is tied together through an integrated communications link. The communications between various components of the system are bi-directional, an attribute described as affording the opportunity to change data sampling rates and select which parameters to monitor from the remote location The thrust of the Reuss Patent is the collection of data from monitors so that the data are available to a caregiver. The caregiver may view the data on a display or request the data for viewing.
U.S. Pat. No. 4,838,275 issued to Lee for a “Home Medical Surveillance System,” describes an apparatus for use in a patient's home that includes special furniture on which the patient lies and sits. Embedded in this special furniture are devices that automatically sense multiple parameters related to the patient's health. The disclosed invention is directed to monitoring individual ambulatory patients in a home environment. However, this monitoring is not stated to be continuous.
U.S. Pat. No. 3,646,606 issued to Buxton et al. for a “Physiological Monitoring System,” describes an apparatus for measuring physiological parameters indicative of the condition of a patient and sending those parameters to a central monitoring station. The central monitoring station would display the parameters in analog and digital form issue an alert signal in the event certain parameter values are detected. Viewing patient data is accomplished by selecting a patient using a switch (FIG. 3, callout 122). Thus, not all patients are monitored at all times. The described invention is directed to a data gathering system combined with a single event driven process to manage “emergencies.” Data is presented to a single operator and, except for certain alert conditions, the evaluation of that data is charged to the single operator.
While these inventions provide useful records management and diagnostic tools, none of them provides a comprehensive communications system that incorporates for monitoring and providing real time continuous assessment and intervention of monitored hospitalized patients at disparate patient monitoring stations.
What would be useful would be a communication network for automated monitoring of multiple hospitalized patients, capable of using diverse data sources to provide a continuous assessment of a patient's condition. Such a network would support computerized diagnostic tools to aid caregivers in identifying and treating hospitalized patients who would benefit from monitoring and assessment. Such a network would further comprise the ability to flexibly and individually establish and/or revise alerts for patients from a central location based on individualized patient parameters and to utilize computer based algorithms to a communications network optimized for intervening appropriately.